Birthing Etiquette ﻿Minding manners in a sensitive situation

﻿Not so long ago, a father’s expected role during birth was to pace the hall outside the delivery room. Expectant mothers turned to their doctors and other hospital staff for both medical advice and support. The entire process was a private event between a woman and her health care providers.

Times have changed and the process of childbirth has evolved. Childbirth is more patient-centred and the arrival of the Internet has exposed parents to a greater number of options. Even more, childbirth is no longer just a medical procedure, but is often an event with many social overtones. Changes in the way we handle birth have led to a need for birthing etiquette. This term is unfamiliar, since until now it was not really necessary. Like anything else, rules about acceptable behaviour exist for the process of birth.

Birth etiquette involves:

communication tools, such as birth plans, used between expectant parents and the health care team

the role of the student in the private birthing experience

the behaviour of family and friends in hospital birthing and postpartum (after delivery) units

guidelines for family and friends once the baby and family are home from hospital.

Etiquette has a definite place in the world of labour and delivery. Using it builds relationships and communication, while establishing a sense of comfort. Etiquette helps make the birthing experience rewarding for everyone involved.

Communication

It is not uncommon for a mother to arrive at her doctor’s office with a birthing plan. This new concept is a well-thought-out outline detailing the wishes of the parents for the birth. Some go as far as to indicate the exact timing preferred for clamping and cutting the cord. It is easy to find birthing plans. Many samples exist on the Internet, some as long as 17 pages.

Health care providers view these plans with cautious optimism. Birthing plans benefit the parents in that they encourage thought and research into what to expect during labour and delivery. However, a birthing plan can also be a barrier and a source of disappointment if things do not go according to plan.

Such a plan may seem unnecessary, since most of the items listed involve routine care. This care is often discussed during the frequent prenatal office visits. Despite their best intentions, most doctors do not have time to read lengthy documents. Rather, they prefer to discuss the issues important to the expectant parents. Using a written birth plan rather than discussion is indirect. Communication is crucial and much more effective done face-to-face over a period of time. Parents-to-be can take an active role by choosing a doctor with whom they connect and who shares their values.

Birthing plans have a definite place when expectant parents want to make birth more personal. For instance, they may want to videotape the birth, play music, or have scented candles in the room. The plan is a great way to sum up discussions that have taken place between expectant parents and their care providers.

Etiquette calls for balance and understanding. Everyone needs to stay flexible and keep an open mind. Remember, we all have the same goal: the best outcome for both mother and baby. Communicating openly in a respectful and understanding manner is an essential part of birthing etiquette for those involved.

Teachers and learners

With the increasing number of teaching hospitals, it is likely that a labouring mother may be asked if she would mind if a student is involved in labour and delivery care. Without an understanding of the student’s role, the first instinct is usually to say no. However, it is important for a mother to understand why a student is there and what this person can do for her.

Adding another unfamiliar face to a setting that calls for privacy and intimacy can be uncomfortable. Such feelings are respected and shared by the medical staff. At the same time, adding a student into the picture may actually improve the experience.

The learner may be a nursing, midwifery or medical student, or a resident in any given year of training. Others include emergency medical technician students who will eventually staff ambulances or respiratory technology students. They are all eager to learn and want to help in any way, whether that means providing comfort with a massage or bringing ice chips and water.

The student is there to gain hands-on experience, but it goes beyond that. To know that they have helped in any way is exciting and uplifting. It can even affirm why they entered the health care field – to help others. Such experiences are unforgettable, and can bolster health care workers during the difficult times.

An instructor accompanies and monitors each student, making sure that details are not overlooked. As the student is taught, expectant parents can also benefit by learning how and why certain things are done.

All medical interventions are done professionally and with the patient’s dignity in mind. Exams of the birth canal are done only to check the progress of labour and are usually double-checked by the instructor.

When a student cares for a labouring mother, the care received is no less effective, attentive or exact. In fact, some people believe it is the opposite. Students pride themselves on detail and go to great lengths to ensure that a patient is satisfied.

Birth etiquette asks parents to keep an open mind to the involvement of those who are learning. For the student, etiquette calls for understanding, professionalism and respect of patient wishes. However, mothers should know that they have the right to refuse a student if they wish, without worrying about the quality of care.

Family and friends

At the hospital

After nine months of planning and anticipation, the big day arrives. The mother and father-to-be are ready for the birth of their baby. Family and friends must realize that childbirth is not a spectator sport. The only people who should be present during labour and birth are those invited by the mother who will help in the birthing process. It can be very distracting to have people arriving at the hospital uninvited, walking in and out of a birthing room. Children running up and down the hallway can disturb other labouring women.

Immediately after the birth, the parents may want private time to bond with their newborn and learn to breastfeed. They may not be ready for visitors for quite a while. There will be plenty of time to meet the baby once the new parents are ready to share their joy.

Parents may decide to use one person as a main contact. When the baby is born, they may make one or two phone calls, then have their messenger alert the rest of the world.

Once the new family member has arrived, it is smooth sailing from there on in, right? Wrong! After delivery, mom and baby are usually transferred to a postpartum unit. Lack of sleep is common, and learning the art of breastfeeding may not be as simple as mom had anticipated. This time can be an emotional rollercoaster, made worse by changing hormone levels. Even under the best circumstances, the focus should be on creating a peaceful environment so mother and baby bonding occurs and breastfeeding is successful.

Unfortunately, well-meaning family and friends may crowd into a small hospital room for long periods bringing flowers, well wishes and parenting advice. Birth etiquette allows parents to set limits. Ideally, they should express these wishes before leaving for the hospital.

Hospital visits should be discouraged or very short. Having a quiet environment affects not only the mom in question, but also the other new mom in the next bed. Both are likely going through similar physical and emotional extremes and challenges. New mothers do not get to sleep through the night and need naps during the day.
Etiquette also suggests new dads do not spend the night in a semi-private (two bed) hospital room.

A mother’s sense of decency is challenged enough during labour and delivery. It is not necessary to further expose a neighbouring new mom to an unknown man spending the night just a few feet away. Postpartum staff and new moms should kindly send fathers home after visiting hours are over.

Maintaining birth etiquette requires sympathy and understanding. Put yourself in the new mom’s position. How would you want your environment to be to ensure that your baby’s first few days of life are soothing and secure?

At home

Coming home with a new baby is exciting, the beginning of life as new parents have never known it. Parenting is a selfless journey, where the baby comes first. This selflessness does not extend to well-meaning neighbours, family, and friends. New parents should not hesitate to make their needs clear. Visitors are welcome but encouraged to bring food and keep the visit short. While this may sound harsh, imagine learning to care for a new baby while sleep-deprived and trying to entertain a group of excited family and friends. Caring family and friends will understand. Offering advice when it has not been requested does not help either.

Etiquette involves self-respect and love. It is easy for a new mom to be unrealistic, expecting to be the perfect mother while keeping the house clean and preparing home-cooked meals. This is not practical. New moms and dads can gratefully delegate tasks such as grocery shopping, cleaning and cooking to those who want to help. Don’t worry, you will have the chance to pass on the favour when the next baby arrives within your circle.

Birth etiquette is a necessary and important part of the birthing process. It should be included in discussions and activities before, during and after delivery. Etiquette reminds us to respect ourselves, others and the environment into which babies are born. Birthing etiquette results in the best beginning for everyone involved.